Abstract
Clostridium difficile naturally inhabits intestinal tract of animals including humans. Spores of C. difficile are known contaminant in the Environment. Indiscriminate use of antibiotics has led to the emergence of a powerful resistance determinant (known as Metallo resistant genes) in many bacteria worldwide. Multidrug resistant bacteria (MRB) pose threats to health globally. This study aims to determine the distribution of Metallo resistant Clostridium difficile in hospital environment within Yola. A total of 150 surface samples from the hospital wards were collected from Federal Medical Centre, Yola (FMC) and Specialist hospital, Yola (SHY) Adamawa state, Nigeria. Clostridium difficile were recovered by inoculating samples in modified Cycloserine-cefoxitin fructose broth (CCFB) and Cycloserine-cefoxitin fructose agar (CCFA). Screening of isolates for extended spectrum β-lactamase (ESBL) and metallo-β-lactamase enzymes was done by double disc diffusion method and Imipenem-EDTA combined disc test respectively. A total of 18 C. difficile isolates were obtained and found to be extended spectrum β-lactamase (ESBL) positive. 16 (88.89 %) of the Clostridium difficile were found to be metallo-β-lactamase positive. Polymerase chain reaction showed that 11(61.1 %) of the isolates possess bla-IMP metallo resistant gene. This study suggests that multidrug resistant C. difficile with metallo resistant genes are wide spread in hospital settings and there is need for relevant authorities to improve on the sanitization of environment as well as continuous surveillance to hinder C. difficile transmission.
Highlights
Clostridium difficile infection has been regarded as a nosocomial infection in human especially in patient receiving prolonged antibiotic therapy [1]
Clostridium difficile have several metallo beta-lactamase (MBL) genes among which are beta-lactamase like protein, beta-lactamase like hydrolase, beta-lactamase inhibitor protein II, metallo-beta lactamase superfamily protein, metallo-beta lactamase superfamily hydrolase, metallo-beta lactamase superfamily exported protein, cell surface protein penicillin-binding protein amongst others [11]. bla-IMP and bla-VIM are the most common MBL genes described throughout the world [12]. bla-AIM, bla-GIM, bla-SPM, bla-SIM, NDM-1 are the other types of MBL genes found only sporadically in some geographical regions [13]
A study by Fawley and Wilcox [25] showed that C. difficile remained viable in one third of surface samples taken from the hospital rooms of pseudomembranous colitis patients with (PMC)
Summary
Clostridium difficile infection has been regarded as a nosocomial infection in human especially in patient receiving prolonged antibiotic therapy [1]. The most important determinants of Clostridium difficile infection are exposed to the organism and treatment with antibiotic [3]. Βeta-Lactamases are enzymes which hydrolyze the β-lactam ring of Penicillins, Cephalosporins, Monobactams and Carbapenems This is an important mechanism of microbial resistance to β-lactam antibiotic [6]. Genes encoding for MBL are located on the integron structures that resides on transposons or plasmids [9] enhancing dissemination They are unique in their ability to hydrolyze carbapenems and be inhibited by EDTA chelators of Zn2+ [10]. Difficulty in management and increased hospital stay of patients with serious infections due to MBL organism are attributed to continuous treatment with antibiotic to which complete resistance has developed [14]. Detection of MBL producing organisms especially C. difficile is highly significant for optimal treatment and controlling the spread of drug resistance organism
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